Clickable Table

Generic Name Brand Name Strength Dosing 90 Day Cost Coverage Comments Category 1 Category 2
Testosterone Gel Androgel 5 g QD $470 BC - NC / NIHB - SA Urology Testosterone Replacement
Testosterone Enanthate Delatestryl 200 mg/mL 400 mg Q30D $80 BC / NIHB - Covered Urology Testosterone Replacement
Testosterone Cypionate Depo-Testosterone 100 mg/mL 200 mg Q2W $60 BC / NIHB - Covered Urology Testosterone Replacement
Tadalafil Cialis 20 mg As dir $70 BC / NIHB - NC

4 tablets; may split tablet for lower dose to save costs

Urology Erectile Dysfunction
Vardenafil Levitra 20 mg As dir $70 BC / NIHB - NC

4 tablets; may split tablet for lower dose to save costs

Urology Erectile Dysfunction
Sildenafil Viagra 50 mg, 100 mg As dir $55 BC / NIHB - NC

4 tablets; may split tablet for lower dose to save costs

Urology Erectile Dysfunction
Testosterone Undecanoate Andriol 40 mg BID $105 BC - SA / NIHB - Covered Urology Testosterone Replacement
Testosterone Patch Androderm 5 mg/day QD $475 BC - NC / NIHB - SA Urology Testosterone Replacement
Tamsulosin CR Flomax CR 0.4 mg QD $30 BC / NIHB - Covered Urology Benign Prostatic Hyperplasia (BPH)
Terazosin Hytrin 2 mg QD $65 BC / NIHB - Covered Urology Benign Prostatic Hyperplasia (BPH)
Finasteride Proscar 5 mg QD $50 BC / NIHB - Covered Urology Benign Prostatic Hyperplasia (BPH)
Dutasteride Avodart 0.5 mg QD $40 BC / NIHB - Covered Urology Benign Prostatic Hyperplasia (BPH)
Legend:
BC = Alberta Blue Cross, NIHB = Non-Insured Health Benefits for First Nations and Inuit, NC = Not covered, SA = special authorization, SR = sustained release, OTC = over the counter, SQ = subcutaneous injection, SS=Social Services